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Dental problems in Maltese x Shih Tzu dogs are relatively commonplace, and in fact I would list oral issues as being one of the most common health concerns for which this breed visits my veterinary consult room.
As any owner will tell you, the Maltese Shih Tzu hybrid (better known as the ‘Malshi’) is nothing if not unique, and this is also true when it comes to oral health considerations. Malshis are prone to congenital underbite, as well as dental malocclusion, overcrowding of the teeth, and periodontal disease. If you’re not sure what these terms mean just yet, that’s OK! We’ll run through them one by one in this article, and I promise it’ll all make sense by the time you’ve finished your cup of tea.
Dental care and oral hygiene are incredibly important in terms of a dog’s overall health, well-being and quality of life. Vets have known for quite some time that untreated dental disease can have far-reaching effects throughout the body, for example increasing the risk of a pet developing liver or kidney disease. This is because bacteria from the oral infection can find their way into the bloodstream, sneakily hitching a ride to target organs far away from the mouth.
So, keeping those mouths clean and those teeth sparkling really is super important for your Malshi’s health; it’s not just about keeping up appearances!
Signs and Symptoms of Common Dental Problems in Maltese x Shih Tzu Dogs
Perhaps the most prevalent dental issues in Maltese x Shih Tzu hybrids are congenital underbite and tooth overcrowding (leading to malocclusion), as well as periodontal disease.
Malocclusion
First, let’s explain the meaning of the term ‘malocclusion’. Malocclusion refers to abnormal positioning of your dog’s teeth, meaning the upper and lower teeth don’t align well when they bite down. Basically, malocclusion is what your dentist is checking for when they get you to bite your teeth together at your own appointment! Both underbite and overcrowding can be causes of malocclusion in Maltese Shih Tzu mix dogs.
Underbite
If your Malshi has an underbite, you will notice that their lower jaw protrudes (sticks out) further than their upper jaw. And ‘congenital’ is just a fancy way of saying that it’s a condition your dog was born with. Unless it’s very severe (enough to interfere with the ability to eat, drink and hold toys etc with the mouth) an underbite is not a life-limiting condition…however, if your Maltese x Shih Tzu has an underbite they may be more prone to periodontal disease compared to a Malshi with no underbite.
Periodontal Disease
Periodontal disease is a progressive, inflammatory condition which eventually leads to tooth loss if left untreated. It occurs due to inadequate dental hygiene in our canine family members, and it’s crazy common! In fact, some studies suggest that as many as 90% of dogs aged 3+ years have some degree of periodontal disease, and the condition is more prevalent in small breeds (such as the Maltese Shih Tzu mix).
The first step of periodontal disease is the formation of plaque (a clear, sticky film of bacteria, saliva, and food particles) on the teeth. The plaque formation stage takes about 24 hours. Unless plaque is removed by daily tooth brushing, it will become tartar (a hard, yellow-brown mineral layer which is far trickier to remove) after 24-48 hours.
The presence of increasing amounts of tartar aggravates the gums, resulting in gingivitis, which is characterized by red, swollen and bleeding gums. Bacteria thrive in these conditions. Eventually, inflammation and destruction spread throughout the normal supporting structures of the tooth and the jawbone. Tooth loss and/or dental abscesses frequently result.
Signs of periodontal disease to be vigilant for in your Malshi include bad breath (halitosis), red or bleeding gums, difficulty eating, loose teeth (or even tooth loss) and oral pain. Keep an eye out too for any chipped, fractured or discoloured teeth, as these will also need prompt attention from a veterinary surgeon.
Tooth Overcrowding
The final condition we need to discuss in relation to Maltese Shih Tzu oral care is tooth overcrowding. The Malshi is a brachycephalic breed, which means these sweet little guys have a relatively flattened face. However, despite a fairly flat face and small muzzle, just like longer-nosed breeds, they still need to cram fourty-two teeth into their mouths somehow!
As a result, the teeth are often quite crowded and, in some cases, there isn’t space for every adult tooth to erupt into the mouth. Often, teeth will appear to be missing upon oral exam but will be present unerupted, below the gumline, on dental X-ray.
The main problem with overcrowding is that – like underbite – it encourages periodontal disease. Sometimes, extractions (removal of a tooth or teeth) will be recommended. In other cases, simply keeping on top of your Maltese Shih Tzu’s oral hygiene will be enough to manage the condition.
FAQ: “How many teeth does a Maltese Shih Tzu have?
Who would have thought that a Malshi fits 42 teeth into their little mouth!”
Early Detection and Preventing Dental Problems
Early detection and intervention before dental issues become a major problem is super important, because early periodontal disease is reversible with treatment, whereas advanced periodontal disease (which has been left untreated for some time) will cause permanent, irreversible damage to your Malshi’s teeth and supporting oral structures (the jaw bone, soft tissues and ligaments).
As such, it’s vital to make it a habit to check your Maltese Shih Tzu’s mouth regularly (ideally daily, alongside routine brushing of the teeth) for any problems.
Brushing Your Maltese x Shih Tzu’s Teeth
If you aren’t already doing this, the best time to start brushing your Malshi’s teeth is – probably now!
I say “probably”, because in some cases where there is already extensive periodontal disease and/or gingivitis present, tooth brushing can be quite painful for the dog, and your pet will need dental treatment from a veterinary surgeon under general anaesthesia to remove tartar and extract any irreversibly diseased teeth, before you add routine tooth brushing into your Maltese x Shih Tzu’s daily schedule. If in doubt, check with your vet before you start.
To be most effective, tooth brushing should be undertaken daily. Studies have shown that brushing a dog’s teeth less than three times weekly actually has zero effect in terms of preventing periodontal disease! So, at a bare minimum brushing should be undertaken every 48 hours, but ideally (for best results) aim to do this daily.
You’ll need to use toothpaste specifically formulated for dogs (never human toothpaste, which can contain ingredients which are toxic to our canine companions), and a toothbrush with soft bristles (a child’s toothbrush from your local drug store will work well).
If you’re new to brushing your Malshi’s teeth, start slowly and familiarise your dog with the toothbrush and toothpaste gradually. You can allow them to sniff and lick the toothpaste to become accustomed to its smell and taste. Remember to offer plenty of praise and treats to keep the experience positive!
Once your Maltese Shih Tzu is happy to accept this, you can progress to lifting your dog’s lip and gently brushing in a circular motion, focusing on the area where the teeth meet the gums.
Be patient and persistent. Start with short sessions of just a minute or two, and gradually increase the duration as your Malshi becomes more comfortable with the process.
Doggie Dental Health Aids
The fact is, whilst dental diets, treats, chews and plaque-removal products are becoming increasingly popular, all the evidence we currently have suggests that daily tooth brushing makes the biggest difference by far in terms of preventing dental issues in Maltese Shih Tzu hybrids. Additional dental health aids make a relatively small difference, by comparison, but are still worth adding in for your pet.
Feeding a kibble diet rather than a wet ‘meaty’ diet can help your Maltese Shih Tzu mix avoid dental issues because the crunching of kibble can help to literally scrape plaque from the teeth. Dental chews help in a similar manner but do be aware that not every brand has conducted any studies to show that their formulation and shape of their chews are effective in removing plaque; some have though, so do your research and pick a brand of chew that has been proven to work, such as Pedigree Dentastix.
Making your Maltese Shih Tzu’s dental health a priority now can save you time and money and save your pet considerable discomfort down the line. So, there’s no better time to get started with preventative measures, and of course, don’t skip on your Malshi’s regular dental checkups with their veterinarian.
Most small breed dogs should see a vet at least twice yearly to have their teeth checked; sooner if you have any concerns. When it comes to overcoming dental problems in Maltese x Shih Tzu dogs, prevention is definitely preferable to cure.
Daisy qualified with distinction from the University of Liverpool Vet School in 2019. During her academic years she completed a wide variety of placements, including a competitive final year elective at Chester Zoo – one of the largest zoos in the United Kingdom! Since graduating, she has hung up her zoo medicine hat and focused her attention on smaller patients, developing a particular passion for feline and canine internal medicine and dentistry.
Daisy has spent the last two years working in first opinion small animal practice as a consulting and surgical Vet. A typical day can involve anything from routine procedures, diagnostic imaging and consulting, right through to life-saving emergency surgeries. When she is not in the clinic, you’ll find her at her laptop in a shaded part of the garden, cup of tea in hand, authoring practical and easy-to-follow pet care articles to ensure top quality advice is available to each and every “pet parent” at the touch of a screen.
